| CONTACT INFORMATION |
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| Name of School |
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| Contact Person |
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| Mailing Address |
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| E-mail |
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| Phone |
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| Fax |
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| PREFERRED VISIT DATES |
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| Fall Semester |
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| First preferred date |
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| Second preferred date |
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| Third preferred date |
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| Spring Semester |
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| Month |
|
| Day |
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| Date |
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| TIME Sample Itinerary |
| Arrival Time |
10:00 a.m. |
| Departure Time |
2:00 p.m. |
ADDITIONAL SPEAKER (optional) Please check one |
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| |
College of Education College of Engineering & Engineering Technology College of Health & Human Sciences College of Liberal Arts & Sciences College of Visual & Performing Arts Black Studies, Center for Latino Resource Center LGBT Resource Center Study Abroad Transfer Center Women's Resource Center
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| LUNCH |
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We Will Bring Our Own Brown Bag Lunch |
| ATTENDANCE |
|
| Number of Students |
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| Number of Staff |
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| GRADE LEVEL(S) |